title: Population attributable risk of modifiable risk factors associated with invasive breast cancer in women aged 45-69 years in Queensland, Australia.
abstract: OBJECTIVE
  To quantify the population attributable risk of key modifiable risk factors associated with breast cancer incidence in Queensland, Australia.
  
  
  METHODS
  Population attributable fractions (PAFs) for high body mass index (BMI), use of hormone replacement therapy (HRT), alcohol consumption and inadequate physical activity were calculated, using prevalence data from a representative survey of women attending mammographic screening at BreastScreen Queensland in 2008 and relative risk estimates sourced from published literature. Attributable cancers were calculated using 'underlying' breast cancer incidence data for 2008 based on Poisson regression models, adjusting for the inflation of incidence due to the effects of mammographic screening.
  
  
  METHODS
  Attributable burden of breast cancer due to high body mass index (BMI), use of hormone replacement therapy (HRT), alcohol consumption and inadequate physical activity.
  
  
  RESULTS
  In Queensland women aged 45-69 years, an estimated 12.1% (95% CI: 11.6-12.5%) of invasive breast cancers were attributable to high BMI in post-menopausal women who have never used HRT; 2.8% (95% CI: 2.7-2.9%) to alcohol consumption; 7.6% (95% CI: 7.4-7.9%) to inadequate physical activity in post-menopausal women and 6.2% (95% CI: 5.5-7.0%) to current use of HRT after stratification by BMI and type of HRT used. Combined, just over one quarter (26.0%; 95% CI: 25.4-26.6%) of all invasive breast cancers in Queensland women aged 45-69 years in 2008 were attributable to these modifiable risk factors.
  
  
  CONCLUSIONS
  There is benefit in targeting prevention strategies to modify lifestyle behaviours around BMI, physical activity, HRT use and alcohol consumption, as a reduction in these risk factors could decrease invasive breast cancer incidence in the Queensland population.
authors.affiliation: School of Population Health, University of Queensland, Public Health Building, Herston Road, Herston, QLD 4006, Australia. Electronic address: l.wilson8@uq.edu.au.
authors.forename: Louise F
authors.initials: LF
authors.lastname: Wilson
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Page
authors.forename: Nathan A M
authors.initials: NA
authors.lastname: Dunn
authors.forename: Nirmala
authors.initials: N
authors.lastname: Pandeya
authors.forename: Melinda M
authors.initials: MM
authors.lastname: Protani
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Taylor
mesh_terms: D000368:Aged; D000428:Alcohol Drinking; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D004967:Estrogens / Q000009:adverse effects; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008327:Mammography; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D017698:Postmenopause; D015995:Prevalence; D011793:Queensland / Q000453:epidemiology; D012044:Regression Analysis; D012307:Risk Factors; D057185:Sedentary Behavior
chemical_list: D004967:Estrogens
keywords: Australia; Breast cancer; Modifiable risk factors; Population attributable risk